There is concern that a sizable number of the confirmed cases of monkeypox in the UK and NI have been in gay and bisexual men. However, anyone with monkeypox can pass it on, regardless of sexual orientation.

It is a rare virus caused by an infection, it is a mild self-limiting illness (meaning that whilst some may experience symptoms that affects their ability to perform daily activities for a short time, others will be able to carry on as normal) and most people recover within a few weeks. Cases are low within Northern Ireland and the majority of the confirmed cases are within England.

Most people will recover within a few weeks without any treatment. Treatments such as ibuprofen and paracetamol can help with fever and aches. Sometimes people become more unwell and need to be admitted to the hospital.

At the minute, vaccine supplies are limited and will be given to those at the highest risk. In order to get vaccinated, there are a number of factors that will be taken into consideration. It is done through a similar process to assess those who need PrEP (HIV Pre-exposure prophylaxis).

The GUM Clinic will be identifying those who are eligible for the vaccine and phoning them directly.

Initial Symptoms:

• Fever
• Headache
• Muscle aches
• Backache
• Swollen lymph nodes
• Chills and exhaustion

Secondary symptoms:

• A rash develops on the face, then spreads to other parts of the body (including genitals)
• The rash can change and go through different stages, it’ll look similar to chickenpox or syphilis before forming a scab which will fall off.

If you are concerned about it or have been in close contact with someone with a confirmed case of monkeypox then please contact your local GUM clinic. If you have developed a new rash or symptoms please ring before going.

It can take up to three weeks for symptoms to appear and the main symptom to look out for is the rashes, blisters and lesions.

How is it transmitted:

Monkeypox can be transmitted to anyone through close, personal, often skin-to-skin contact including:

• Direct contact with monkeypox rash, scabs from a person with the virus.
• Transmitted by direct sexual contact, touching, kissing, hugging of the body or prolonged face-to-face contact.
• Contact with body fluids from a person with monkeypox (this can include semen, phlegm produced in coughing or saliva)
• Touching objects, fabrics (clothing, bedding, or towels), and surfaces that have been used by someone with monkeypox.
• Sharing or touching of items such as toys or clothing.

If you are engaging in sex, please talk to your partners about whether they’ve experienced any of the above initial symptoms (aches, chills, fatigue etc.) or if they’ve noticed any sores, rashes or scabs on their body. If their answer is yes, it’s best that you reschedule your hook-up until they’ve been tested or their symptoms have subsided.

If you are noticing symptoms, don’t engage in sexual activities and avoid close contact with others as it could pass the virus on. Don’t share things like towels, fetish gear, sex toys, toothbrushes and clothes. If you can’t avoid sharing the items, wash them beforehand to try and eliminate any germs.

When to get tested:

It’s strongly advised that as soon as you start showing symptoms of any kind, to contact your local GUM and get tested. Especially if:

• You have been in close contact with someone who has or might have monkeypox in the past three weeks
• Have been to the west or central Africa in the past three weeks,
• You’ve travelled to an area where there’s a current outbreak (Spain, Portugal and USA) 21 days prior to your symptoms starting

You can’t go to your GP or GUM Clinic without ringing them first to make them aware you’re concerned you may have contracted Monkeypox. They need to safeguard other staff and service users as this virus can be passed by touching shared items. So please do not attend without ringing first!

If you’re struggling to get through to your local GUM clinic or GP you can contact Leo to try and help you arrange an appointment for testing.

• Phone: 028 90 319 030
• E-mail: leo@rainbow-project.org
• Text/Call: 079 04 864 861

Getting Tested

Before you go to your GP or to the GUM Clinic, ring ahead to ensure they have availability for an appointment and that they’re aware you’re attending due to concerns that you may have contracted Monkeypox. You’ll then go through a simple viral swab, this will be taken from your nose and throat.

As soon as you think you are experiencing any of the outlined symptoms or are concerned you may have been in close contact with someone who has Monkeypox, call your GP or GUM clinic to get advice or an appointment for testing.

Vaccination Programme:

It is important to remember that anyone can get Monkeypox. However, as the initial UK outbreak came from within the gay and bisexual men’s community that has meant that men who are gay, bisexual or who have sex with men are more likely to be at risk.

To get vaccinated there are a number of factors that will be taken into consideration. It is done through a similar process to assess those who need PrEP (HIV Pre-exposure prophylaxis). The GUM Clinic will be identifying those who are eligible for the vaccine and phoning them directly.

The vaccination is currently being offered to:

• Healthcare workers who are caring for and who are due to start caring for a patient with confirmed monkeypox
• Gay, bisexual and other men who have sex with men but only if you have multiple partners, participate in group sex, engage in sex work or attend ‘sex on premises’ venues
• People who have already had close contact with a patient with confirmed monkeypox.

Are there side effects when receiving the Monkeypox vaccine?

Like all vaccines, it can cause side effects, but most of these are mild and short-lived and not everyone gets them.

How effective is the Monkeypox Vaccine?

After 2 doses of vaccine, most people develop antibodies and should therefore have a good level of protection against monkeypox. It is less clear what level of protection you get from a single dose given after contact with a case.

Why do I have to wait to get my Monkeypox vaccine?

There is a limited supply of the MVA vaccine so, initially, one dose is being offered to those at highest risk. As more vaccine supplies become available, more people will be offered the first dose of the vaccine. Additional supplies are expected soon and those next in line will be offered the vaccine as soon as it becomes available

How to lower your risk of contracting Monkeypox:

If you aren’t classified as high risk or are not being offered the vaccine at the moment, there are several ways to go about protecting yourself.

• Using condoms and lube is as important as ever in protecting you and your partner(s). We’re providing free safer sex packs across Northern Ireland, which you can order here
• Limit the number of new sexual partners you have.
• Talk to your partners about safer sex and discuss any symptoms. But be kind too. Lots of other skin conditions that can look similar, and may not be infectious. If you suspect somebody else has symptoms and you talk to them about it, be respectful and don’t make judgements
• Remove yourself from situations where you are unsure of the risks.
• Avoid kissing or exchanging of spit.
• Explore virtual sex without skin-to-skin contact.
• Remember to practise good hygiene (washing hands, fetish gear, toys, bedding, clothes.)
• Be aware that shared spaces like saunas, clubs or parties where anonymous contact will have a higher place of high risk. You can still reduce your risk by not sharing towels and not using rooms or equipment directly after somebody else.
• Try to have a conversation with your partner if they are displaying symptoms or remove yourself from the situation if you are displaying them.

Other Resources on Monkeypox:

• Why do I have to wait for my monkeypox vaccine?
• Information on the smallpox vaccine being used to protect against monkeypox.
• Don’t let monkeypox spoil your Pride
• nidirect information about monkeypox
• Centre for Disease Control & Prevention (CDC) information on monkeypox
• CDC information on monkeypox & safer sex.